Thank you for the opportunity to present an overview of Ontario's bridge training programs. Immigration is fundamental to Ontario's economic future, and Ontario recognizes the increasingly important role that immigrants will play in the province's economic growth as our labour force continues to age and retire. That's why Ontario invests in a variety of programs that help immigrants gain the skills and tools they need to enter the labour market.

Prior to the Ontario bridge training program in pharmacy, as offered by the University of Toronto, the pass rate on the pharmacy exam was 20% for those who took the exam. Thanks to the Ontario bridge training program in pharmacy, Ontario has raised that pass rate to 90% by funding the start-up of the pharmacy bridge training program. That program offers intensive short-term training. For those who pass the exam, the employment rate is close to 100%.

This is the kind of outcome we're looking for in our bridge training programs and what I want to share with you here today.

The main objective of these programs is to achieve exactly these kinds of results through short-term, intensive, specialized, and sector-specific training and employment services. These programs help internationally trained individuals meet the requirements for licensure and employment in their field without duplicating what they already know. The programs complement Ontario's employment services and our province's post-secondary education system.

Since 2003, Ontario has invested over $183 million in more than 240 bridge training programs. These programs have helped over 42,000 internationally trained individuals find work that is in line with their education and experience.

We're looking for two key results with this type of programming.

The first result is for those seeking employment in a regulated profession. We're tracking licensure outcomes and employment outcomes.

The second result is for those seeking work in highly skilled professions that are non-regulated. We want to see employment outcomes and employment at a level commensurate with their skills and education. Getting just any job isn't what we're interested in; it's commensurate employment.

Today I want to talk more about how these programs achieve this type of success. Therefore, it is the who, what, and why of bridge training that I'm going to give you--as fast as I can--and include some recommendations on how we can work on this and move this area forward together.

Let me begin with whom these programs are for. The programs are targeted at a very specialized client group. Participants must have a very high level of English or French language already. To achieve the strongest outcomes in the shortest period of time, participants must have a minimum Canadian level benchmark of seven. In fact, many of our programs are now setting that higher, at Canadian level benchmark eight, which is in line with university requirements for language proficiency.

Participants all have post-secondary education and work experience. These are not international students. Participants must be eligible to work in Ontario. In order to meet the needs of Ontario's labour market and of the participants, citizenship status and employment insurance status are not barriers to participation in Ontario bridge training programs.

What outcomes can we achieve with these programs? Over the years, and in partnership with our service providers, we have defined three categories of bridge training programs that are capable of generating strong licensure and employment results.

The first category--the titles are not very creative, I might add--is called “Getting a License”. Those bridge training programs help skilled internationally trained individuals in regulated professions become registered to practice and get employed in that profession. Here we're tracking licensure and employment rates.

Then there's “Getting a Job”--which also not a very creative title, but it does speak to the purpose. These bridge training programs help highly skilled, internationally trained individuals with international backgrounds in non-regulated but high-skilled occupations, such as finance, IT, or human resources, find commensurate employment. Again, with these programs we're tracking employment and commensurate employment.

Finally, our third category is “Changing Systems” projects. These projects support both licensure and employment outcomes by working with regulatory bodies and with employers, for example, to build a more receptive Ontario labour market, one in which our skilled, professional newcomers can compete effectively for work. Under this category, we have pioneered tools that help employers recruit skilled immigrant professionals and integrate them effectively into their places of work.

Why do these programs get results?

We require our programs to offer a continuum of services from assessment to work force integration strategies. These specialized services are delivered directly or through partnerships with other expert service providers. I have a handout that was shared with the committee. It's a colour handout, and it lists the range of services we ask bridge training program providers to offer, depending on the category of program they are targeting.

What I want to focus on are some of the key findings we have learned about what makes for a successful program. I've offered more of those key findings in a binder that is available and will be distributed to the committee, either electronically or in hard copy if you'd like.

Successful programs target one specific occupation. They offer technical language training and communication training, as well as workplace culture orientation. They consult with employers as well as educators and regulators on the technical curriculum and specialized services in employment. They offer participants direct contact with employers, which is key. The stronger that contact is, the better the employment outcomes are likely to be. From a networking event, to a mentorship, to a paid internship, all these activities increase employment outcomes. Successful programs understand that employment services for highly skilled individuals need to be sector-specific. Results are best when service providers have industry-specific expertise. Finally, they engage a wide range of partners, including credential and language assessors, academic institutions, regulators, and employer champions.

Before I move on to my concluding remarks and recommendations, I want to take a brief moment to talk about financial access to these programs. In cases where a bridging program charges a fee or tuition, we are working closely with our service providers and the Ontario Ministry of Training, Colleges and Universities to ensure that participants in bridge training programs offered at post-secondary institutions are eligible for financial assistance, either through the Ontario student assistance program—that's the OSAP loan—or through a new initiative the province has started called the Ontario bridging participant assistance program. The acronym for that is OBPAP. It's a bursary that provides up to $5,000 to cover the tuition, book, and equipment costs of participating in one of our bridge training programs.

Finally, I'd like to offer four key recommendations on how we can move forward together in this area.

We recommend, first, that a national strategy supports provinces, which have responsibility for post-secondary education and employment services such as these bridge training programs. Federal funding for provincial bridge training programs should be allocated on a three-year cycle to better reflect the multi-year structure of the programs that are being offered. I should note that both orders of government and internationally trained individuals already benefit from a contribution agreement negotiated successfully between the federal government and Ontario to support these programs. We look forward to renewing this agreement, this time on a three-year cycle.

Second, we welcome federal support for the national dissemination of strong bridge training programs and tools.

Third, we recommend federal-provincial collaboration on improving access to financial aid for bridge training program participants. The federal government might like to consider a federal bursary that would also cover child care and transportation and/or expand the federal part-time student loan criteria to cover bridging costs for participants in financial need.

Finally, we welcome an opportunity to work collaboratively with the federal government to augment pre-arrival information services and resources, so that our skilled newcomers can really understand how to get started when they arrive here and what resources are available to them to help re-establish their careers here in Canada.

Cathy GiblinRegistrar and Director, Registration Services, College and Association of Registered Nurses of Alberta

Thank you.

Mr. Chairman, honourable members, it's a privilege to appear before you today.

I'm here on behalf of the College and Association of Registered Nurses of Alberta, which is the regulatory body and professional organization for Alberta's 33,000 registered nurses, the largest health profession in our province. Since 1916 we've been established under legislation and responsible for setting requirements to enter the profession, as well as establishing monitoring and enforcement standards of nursing practice.

My comments are framed primarily within the context of the assessment and recognition of internationally educated nurses, or IENs, and are based on our cumulative experience and expertise gained from reviewing and processing more than 9,000 applications from IENs over the last six-plus years.

Between 2007 and early 2009, there was a very proactive recruitment of internationally educated nurses in Alberta. Our regulatory body went from receiving an average of 40 applications per month to receiving more than 450 per month during the peak period. Much of the expertise and experience we've gained, however, is common to other regulated professions and regulatory agencies in Canada.

I'd like to describe a little bit about the steps in the assessment and recognition of IENs, as well as mention a couple of current activities that my organization is involved with. I'll describe some lessons learned, and then offer some recommendations to the committee.

The intent of IEN assessment at our regulatory organization is primarily to determine if an applicant has a combination of education, experience, practice, or other qualifications that demonstrate the competence required for registration in Alberta. Application can and should start when the applicant is still offshore. A number of documents are collected. Probably the most important piece of information we look for very early in the application process is the demonstration of language proficiency, and in Alberta that's English.

Last week you heard from Dr. Pam Nordstrom from Mount Royal University about the substantially equivalent competency assessment process. If we are unable to determine on the basis of paper alone that an individual has the required qualifications and competencies for practice in Alberta, we require a SEC assessment. This uses a combination of written, oral, and clinical skills exam techniques to determine the extent to which a person has the required skills and knowledge. Very often, following an SEC assessment, we will make a determination on the need for additional bridging education. Mount Royal University has been a partner with us in this endeavour since 2005.

Following the successful completion of bridging education, a person becomes eligible for provisional registration and can write the national entry-to-practice exam toward finalization of registration. Work experience in Alberta, with the submission of a satisfactory employer reference, is also required at this point and can be completed as the person is finishing the entry-to-practice exam.

There are a number of activities currently under way in which CARNA is involved, as well as some across jurisdictions and nationally. However, I'd like to highlight two of these initiatives in a little more detail.

This year CARNA learned that we had been successful in obtaining a grant from the federal government through the internationally educated health professions initiative to make a retrospective study of the characteristics and profile of applicants to us over the past five years, and correlate this with their registration outcomes. We are just getting under way with this piece of research, and we hope to have some recommendations for policy change, particularly with a view toward shortening the process that is experienced by our applicants.

The other initiative that I'd like to draw your attention to is the national nursing assessment service project. This was initiated following recommendations arising from the 2005 report called Navigating To Become A Nurse In Canada. The national nursing assessment service project is seeking to establish a single point of contact for internationally educated nurses seeking registration anywhere in Canada. At this point in time, the assessment service is incorporating itself as an entity in Canada and has selected a vendor to provide these assessment services. A funding proposal to support the development of the next phases and to get this assessment service up and running is now before the federal government. The project is a success story considering the level of consensus and support that has been built among 23 regulatory bodies from across Canada, which are involved in the regulation of not only of registered nurses but also registered psychiatric nurses and practical nurses, or auxiliary nurses as they're known in Quebec.

With regard to the lessons learned or experiences acquired in the assessment and recognition of internationally educated nurses, over the past four years we have tracked the numbers of people who have applied to us and the length of time it has taken them to go through the registration and application process. One of the first measures showed us that it takes between 77 and 252 days for an individual to assemble a complete portfolio of documentation from which we, as a regulatory organization, can make an assessment. Following that assessment, it may take between 540 and 768 days from the time someone applies to us until they achieve registration as an RN in Alberta. There are a lot of reasons it can take that much time, and not all of these are within the control of the regulator.

The challenges experienced by individuals very often have to do with obtaining an exit or entry visa to come to the country to undergo assessment or to sit the exam. Sometimes they must enter the country with a student visa to undertake studies but are then required to have a work visa to complete the work experience that's required at the end of the registration process. Very often an individual comes from a country where the system of professional regulation is very different from what they've experienced here in Canada, and gaining an understanding of the processes involved in that system is quite a challenge. In Alberta we also experience issues getting access to both the competency assessment and bridging education.

Regulators experience challenges in sharing information about individuals. Often such sharing is limited by legislation as well, because of differences in our regulations from province to province. Time and volume also impact on our ability to receive and assess applications from internationally trained nurses.

Finally, managing expectations and communications with the wide variety of stakeholders, such as you and other interested parties in this process, is oftentimes quite a challenge for us.

Before I tell you about our recommendations, I would like to say that another very important lesson that has been learned is that a nurse is not a nurse is not a nurse. The health care systems in countries around the world vary a great deal, a fact that is sometimes particularly difficult to overcome for an individual wishing to integrate themselves into our workplace.

I'd like to recommend that the government consider clarifying in policy the difference between newcomers who enter the country under a temporary foreign worker program and those who are seeking to come in with landed status or permanent residence. In Alberta, for instance, many nurses arrive under the TFW program and clearly intend to stay permanently. Doing so becomes a challenge once they've obtained their first visa, and oftentimes they have to change their status at some point along the way.

I think that coordinated and flexible support is needed to increase access to assessment services, language training, and bridging education. Programs are also needed to address the need for workplace integration. We haven't yet experienced anything coordinated going on in this particular area in Alberta.

Finally, I'd like to say that we should not lose sight of the need to ensure quality and safety in the regulation of professionals and to support our regulatory mandate to protect the interests and well-being of the Canadian public.

The Ministry of Training, Colleges and Universities introduced the Ontario bridging participant assistance program, which provides bursaries of up to $5,000 to internationally trained individuals who participate in eligible Ontario bridge training programs offered by Ontario colleges and universities.

The program was a pilot project that was supposed to end in March 2011. I'm just wondering if you could tell me what the conclusions of the pilot project were. Was the project helpful?

I believe that the ministry may continue that program beyond March 31, 2011. I also know that the uptake of that program was very good. According to the comments we've heard, the financial assistance made a difference to an individual's ability to access education. We have a number of stories we've collected from participants, and we've asked people to write in about them. I don't have them with me here today.

We know that it's important for the individuals to know about the bursary. Often the challenge with these programs and services is being able to get the word out there and market them so that people know that there is an option. We have worked with our program deliverers to make sure that potential participants know that there's either an OSAP loan or a bursary for programs at post-secondary institutions.

We have contributed to it by offering what Ontario has done in terms of developing tools. We have participated in the process in a consultative way.

Ontario has, for a number of years, piloted and funded foreign credential recognition tools and processes. Through a competitive call-for-proposal process, we have allowed regulators to come to us and propose that they will develop a tool to assess either language or competence based on experience. We have been funding those tools and instruments for a while.

I mentioned that it would helpful to be able to better share across Canada the work that is effective. I think we have much to learn from all provinces, but we need a way of disseminating those results. Let me give you an example. Our pharmacy program has already been working with British Columbia to offer the Ontario program that's been piloted here and in operation here for a while. Now it's being offered by a university in British Columbia. The curriculum is there. The work has been done. The tools have been created, and now there's another university able to offer that.

In some of the regulated professions, there are only one or two institutions in Canada that are able to offer that kind of training. Veterinary science is very specialized. Optometry is very specialized. Pharmacy is very specialized. Not every university has a pharmacy program. A lot of work is being done across Canada in the nursing area, and I think the nursing regulators have done well to come together and share. There's a variety of different types of curricula that exist that would be useful to share across the country.

Could you elaborate, because you also mentioned in your recommendations the three-year training cycle? I'm just trying to get some sense of the funding. Does the funding need to be for at least three years?

The training cycle for an individual is not three years, but it does take three years to develop curriculum, to pilot test it, and then to get the results and analyze them. We have seen that this is typically a three-year cycle of development.

On the programs themselves, some of the interventions we fund are for 6 weeks and others are for 18 months. When it gets to a program that's beyond 24 months, that's no longer bridging education but retraining and re-education. That's for advance standing in a university program or for going to college for a diploma-level certificate.

But the funding required to pilot test, research, and develop the tools and the programs typically takes about three years. We've tried to do it in two years, but usually the organizations come back, as they need a bit more time, from six months to eight months. So three years is the right cycle for funding developmental pilot initiatives.

Thank you, Ms. Gordon, and Ms. Giblin, for being here. I'm particularly happy that we finally got to the stage where we have some of our friends in the provinces come to see us today.

I have some concerns about what roles the federal government's two ministries, Human Resources and Skills Development and Citizenship and Immigration—and of course the Foreign Credentials Referral Office—and the provinces should be playing in this.

I represent a riding in Mississauga and have tens of thousands of new Canadians living there. All they want to be able to do is to work in whatever profession they know from their country of origin. They don't really want a bureaucratic shuffle regarding who is responsible, where they should go, and why they can't practise being a doctor here but they can somewhere else.

You've given some helpful recommendations today. I wonder if you could expand on where you see our role as the federal government in this, where you see the role of the provinces, and where you see the role of the regulatory bodies. We know that half the challenge is getting the regulatory bodies to recognize a lot of the foreign credentials. You talked about it, Ms. Giblin, from a nurse's perspective and I appreciate that. We want highly trained people practising in Canada and want to know that their standards are appropriate to practise the profession of nursing and many other professions.

Does either one of you want to take a bit more time on how you see the role of those three organizations, so that we're not duplicating what each of us is doing but making the best use of taxpayers' money to help integrate these new Canadians as workers in their professional expertise?

I think I can probably answer the question best by giving you an example, and that would be the national nursing assessment service that I referred to earlier. It is a project that has been under way for the last four years with the support of funding from the federal government. It has brought 23 regulators together.

When the project first started, I was extremely skeptical that we would come to consensus on anything. However, by getting people together in a room for a common purpose over time, we've seen that we have all agreed on what sort of portfolio information should be presented to any regulator for consideration of eligibility for registration. That sounds like a small thing, but it was a tremendous hurdle for all of us to overcome.

I think the other benefit of working in a collaborative fashion like that with the support of our government is that it offers the opportunity for us to have face-to-face dialogue and explore other areas where we can achieve a level of consensus and agree that our standards don't necessarily have to be different from the others.

I think the national nursing assessment service project is one example. It offers a lot of potential to address some of the problems you identified—duplication of services and discoordination of information between the different entities—and put the best use of available resources at the forefront.

In terms of the federal and the provincial roles, I mentioned that Ontario has negotiated successfully a contribution agreement with the Department of Citizenship and Immigration to meet the funding needs of bridge training programs in Ontario. That agreement built on a very successful, although somewhat unique, arrangement that we had with the Department of Citizenship and Immigration to take advantage of the terms under the Canada-Ontario immigration agreement and co-fund bridge training programs. It was a rather cumbersome process. Ontario identified the projects and then, in consultation with the federal government, we actually shared the contracts. In that way we were able not to duplicate funding—because the federal government could have received those proposals as well. We could contract them and each contribute financially to the cost of the programs, and benefit the skilled professionals overall.

With the contribution agreement we've achieved tremendous administrative ease for our stakeholders. The federal government works alongside us and is part of the selection process, in that they see what projects we're recommending. We work side by side as officials to make sure that we're not duplicating funding when submissions come in. That's a very concrete and productive way to make sure we're spending the money where it's going to be of benefit. The contribution agreement is extremely helpful to Ontario; it's a strong model that allows us to integrate the services into our other employment services and post-secondary education services without a lot of jurisdictional duplication.

We collect that information. I have to say that it's not always submitted in the most rigorous manner, but I can answer your question.

The ages range enormously, but most of the individuals are in their thirties to early forties. That fits with the profile of immigrants at the time they come to Canada. Our experience is that they tend to be individuals who've been in Canada very early on in their career. They are people who've been here less than three years. The bulk of the people are split between the very new arrivals who've been in Canada less than three years, and another one-quarter of a per cent of people who participate in our programs and who have been in Canada for longer than five years. They are perhaps a little bit older; they're not in their fifties, but in their thirties and early forties.

You have to understand that we're dealing both with regulated professions and non-regulated professions. I know that the bridge training program providers have said that in a regulated profession, it's not always possible to go back to your profession when you haven't been practising it for a certain period of time. Some of the programs have criteria like that, saying that you must have worked in your profession—even in your home country—but that you cannot have been away from it for more than a period of three or four years.